In a 10-year retrospective review of ocular surface neoplasia, MMC was shown to have a highly effective role as primary therapy for PAM and CCIN and to be useful as an adjunctive to surgery with cryotherapy, brachytherapy for SCC, melanoma and SGC with pagetoid spread.

The various other clinico-pathologic features that indicate a worse prognosis are vascular, lymphatic and orbital invasion, poor differentiation, multicentric origin, duration of symptoms greater than 6 months, a highly infiltrative pattern and pagetoid invasion of the overlying epithelia of the eye lids (4).

4) These cortical insufficiency fractures are so named because they occur along the tensile (convex) surface of the weakened and often bowed pagetoid bone, analogous to the site where the skin of a banana would break upon "snapping" it open.

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